Blood test updated results help needed

[Spurs3]

Got further blood test results after being on 25mcg levothyroxine for 3 months. The results look alot better to me and in line with where the results should be and the doctor confirmed this also but I am very new to this and would appreciate anyone who has better knowledge of thyroid problems to give me some feedback. Thanks

[Lalatoot]

How do you feel. For many of us on here we would be feeling unwell with those results. Once treated with levo, most feel well when their TSH is 1 or below and with a high level of FT4. Everyone is different so if you feel ok then that is fine. However if you still have symptoms then you need an increase of levo.

[humanbean]

Your other page of results only contained one test result :

Serum vitamin B12 : 305 ng/L (Range : 187 - 883)

You could add this to your first post in this thread to keep the info in one place.

[Spurs3 in reply to humanbean]

Hi, I couldn't see a way to add multiple photos to one post. Can you do this? If so please advise.

[humanbean in reply to Spurs3]

No, unfortunately only one picture is allowed per thread and it must be included in the first post in a thread.

[MaisieGray in reply to Spurs3]

Spurs3 A suggestion is to have posted the photo of the long list, and underneath typed these three results and the one result in the other photo. You need only type it as

TSH 3.94 (0.34 - 5.6)

for instance, so four results don't take long; and then all your results are in a single post and members don't have to go back and forwards to interpret what's going on, for you. 🙂

[SeasideSusie Remembering]

Spurs3

The aim of a treated hypo patient generally is for TSH to be 1 or below or wherever it needs to be for FT4 and FT3 to be in the upper part of their reference ranges, if that is where you feel well.

I would imagine you are still symptomatic.

25mcg is a very low starter dose usually given to children, the elderly and those with a heart condition. 50mcg is a normal starter dose for everyone else and retesting should be done 6 weeks after initiating Levo, 3 months is far too long to wait.

Your results suggest an increase in your dose of Levo is needed, 25mcg immediately and retest in 6-8 weeks, retesting and increasing by 25mcg every 6-8 weeks thereafter until your levels are where they need to be for you to feel well. This information was given in reply to your original post here

healthunlocked.com/thyroidu...

Are you addressing the Hashi's as previously suggested?

Your B12 at 305ng/L is too low. ng/L is the same as pg/L. According to an extract from the book, "Could it be B12?" by Sally M. Pacholok:

"We believe that the 'normal' serum B12 threshold needs to be raised from 200 pg/ml to at least 450 pg/ml because deficiencies begin to appear in the cerebrospinal fluid below 550".

"For brain and nervous system health and prevention of disease in older adults, serum B12 levels should be maintained near or above 1000 pg/ml."

Many people with B12 in the 300s have been found to need B12 injections. Check for any signs of B12 deficiency here:

b12deficiency.info/signs-an...

If you have any then you should list them to discuss with your GP and ask for testing for B12 deficiency/pernicious anaemia.

Folate and B12 work together so you should also have folate tested.

You also need Vit D testing.

[SlowDragon Administrator]

Unless over 60 years old, standard starter dose is 50mcg Levothyroxine

The aim of Levothyroxine is to increase the dose slowly in 25mcg steps upwards until TSH is under 2 (many need TSH significantly under one) and most important is that FT4 in top third of range and FT3 at least half way in range

For full Thyroid evaluation you need TSH, FT4 and FT3 plus both TPO and TG thyroid antibodies tested. Also important to test vitamin D, folate, ferritin and B12

Low vitamin levels are extremely common, especially if Thyroid antibodies are raised

Recommended on here that all thyroid blood tests should ideally be done as early as possible in morning and fasting. This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip, best not mentioned to GP or phlebotomist)

Last Levothyroxine dose should be 24 hours prior to test, (taking delayed dose immediately after blood draw).

All four vitamins need to be regularly tested and frequently need supplementing to maintain optimal levels

NHS guidelines on Levothyroxine including that most patients eventually need somewhere between 100mcg and 200mcg Levothyroxine.

nhs.uk/medicines/levothyrox...

Private tests are available. Thousands on here forced to do this as NHS often refuses to test FT3 or antibodies or all vitamins

thyroiduk.org.uk/tuk/testin...

Medichecks Thyroid plus ultra vitamin or Blue Horizon Thyroid plus eleven are the most popular choice. DIY finger prick test or option to pay extra for private blood draw. Both companies often have special offers, Medichecks usually have offers on Thursdays, Blue Horizon its more random

If antibodies are high this is Hashimoto's, (also known by medics here in UK more commonly as autoimmune thyroid disease).

About 90% of all primary hypothyroidism in Uk is due to Hashimoto's.

Low vitamins are especially common with Hashimoto's. Food intolerances are very common too, especially gluten. So it's important to get TPO and TG thyroid antibodies tested at least once .

[SlowDragon Administrator]

You were advised a month ago by SeasideSusie that ferritin was low and that you had Hashimoto's confirmed by high TPO antibodies

Vitamin D and folate need testing if not been done yet

healthunlocked.com/thyroidu...

See a different GP if your own GP will not agree to 25mcg dose increase in Levothyroxine

Bloods should be retested 6-8 weeks after each dose increase

[Angel_of_the_North]

You have low B12 (needs to be at lest 500) and might be anaemic. You need to get folate and ferritin tested (or a full iron panel). You also need an increase in levo as you are currently on a starter dose for a child or elderly person with heart problems. You should get thyroid tested every 6 weeks (shouldn't have been left on that dose for 3 months) and a 25mcg increase in levo until free t4 and free t3 are in the upper part of their ranges and TSH is under1. Tests should be done early in the AM and fasting (regardless of what GP says) as TSH can be affected time of day, food and tea/coffee